Laparoscopy-Assisted versus Open Hepatectomy for Live Liver Donor: Systematic Review and Meta-Analysis

Objective. To assess the feasibility, safety, and potential benefits of laparoscopy-assisted living donor hepatectomy (LADH) in comparison with open living donor hepatectomy (ODH) for liver transplantation. Background. LADH is becoming increasingly common for living donor liver transplant around the world. We aim to determine the efficacy of LADH and compare it with ODH. Methods. A systematic search on PubMed, Embase, Cochrane Library, and Web of Science was conducted in May 2017. Results. Nine studies were suitable for this analysis, involving 979 patients. LADH seemed to be associated with increased operation time (WMD = 24.85 min; 95% CI: −3.01~52.78, P=0.08), less intraoperative blood loss (WMD = −59.92 ml; 95% CI: −94.58~−25.27, P=0.0007), similar hospital stays (WMD = −0.47 d; 95% CI: −1.78~0.83, P=0.47), less postoperative complications (RR = 0.70, 95% CI: 0.51~0.94, P=0.02), less analgesic use (SMD = −0.22; 95% CI: −0.44~−0.11, P=0.04), similar transfusion rates (RR = 0.82; 95% CI: 0.24~3.12, P=0.82), and similar graft weights (WMD = 7.31 g; 95% CI: −23.45~38.07, P=0.64). Conclusion. Our results indicate that LADH is a safe and effective technique and, when compared to ODH.